The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1885-1921, 1887-02-18

ET1ShIIuL nOrCaA1Cy among the CoHs
munity at CO1On-Advice of the Phys
icians-The Only Safe Course-A Pecu-
liar Form of Fever.
A certain grim fascination attaches to
the idea of a community in which death
has bee ome commonplace. A man who
establishes himself in Colon or Panama,
or who undertakes to spend any consider
able time on the Iine knows that the ag
gregate mortality around him is some
thing frightful. He knows of specific
cases in which the statistics of a small
number of lives have been such as to in
dictate certain death as his portion. He
knows that within the last five months
the death rate among the chief resident
officials of the canal company has been
more than SO per cent, a mortality which
if extended to all classes of the commun-
ity would eXterminate every man, woman
and child on the isthmus in six months.
He knows, perhaps, that on the 1st of
last October thirty Italians arrived at Co
Ion under agreement to serve the Societe
des TravauX PHbliQues ct Constructions
de Paris as fOremen; that of these twenty
nine were in perfect health and robust
condition and the remaining one only suf-
fering from debility caused by excessive
sea sickness; that they were at once sent
to the Enterprise dEmperador, where
they were eXcellently housed and had
every advantage of medical attendance;
that on the 23d of the same month only
five of them survived-a death rate
which, if it were universal, would depop-
ulate the earth in less than month.
AN EXCEPTIONAL CASE.
He knows, it is true, of one man who
lived on the isthmus nineteen years, and
who is still in good health. But he knows,
too of men who have lived there for ten
and fifteen years, and then died after
only four or five days illness. All this is
perpleXing But he is the more perpleXed
when he stops to consider that in the in
stance of the five chief officials out of
six, and the twenty-five Italian foremen
out of thirty, the mortality was not from
q contagiOn, was not even from uniform
infection. One man died of a common
remittent malaria fever, another of the
most virulent type of yellow fever, an
other of bilious fever Of an indistinct
character, fourth of acute Bright's dis
ease following a successfully resisted case
of yellow fever. He knows that he ought
not to drink heavily, But he discovers
that the climate superinduces an intoler-
able lassitude which nothing but frequent
stimulants seem to relieve.
One physician prescribes to him regi-
men which is thoroughly impracticable,
tells him to avoid the hot sun, the sudden
showers, the poisonous air of the night
and early morning. Another physician
shrugs his shoulders and says: "Nfy dear
fellow, dress, eat, drink, live, just as you
did at home, and don't worry. None of
us know anything about the predisposing
conditions of these fevers. But we are
not all of US candid enough to say so.
But, above all, don't worry" There would
I, 60, loef toll
sci if it were not interrupted by the ar
rival of a messenger to inform the doctor
that such and such a man has been taken
i'll, that another is dying, and third just
dead.
The plain truth is the only safe course
for a man on the isthmus to pursue is to
leave the isthmus Immediately, and even
then he may, for all that he knows, carry
with him the embryo of fatal illness
which may not develop itself for weeks
and even months. If ever a country
seemed to have incurred the displeasure
of Divine Providence that country is the
Isthmus of Panama.
PECULIAR FORM OF FEVER.
Special interest attaches to a peculiar
form of septic malarial fever occasionally
met with in Panama and Colon. This
fever has but recently been recognized by
the official ply sicians, and no description
of it has yet been published, either in
medical journals or otherwise. 1t is known
among the physicians as Bettelheim's
fever. 1t is of a continuous type, does
not partake of the characteristics of
either typhoid or yellow fever, and yet
is not amenable to the quinine treatment.
Its course is very much that of typhoid,
but post mortem examinations fail to
show the characteristic typhoid LESSONS
From pathological point Of view it is
to be regretted that the religious tenets
dominant among the foreign residents in
Panama make it impossible to perform
autopsies except in some isolated cases.
And it is owing to this circumstance that
the fever in question was not long since
described and discussed in the literature
of the epidemiology. The post mortem
examinations have now, however, aggre-
gated. sufficiently to place beyond dispute
the fact that the fever is clearly distinct
from typhoid. Its traces are cerebral con-
gestion, gastric and enteric hemorrhagic
illusions, and in general the appearances
consequent upon death from common
malaria Most of the cases occur among
wel[to-do residents of Panan1a.-Colon
Cor. New York Tribune